Patent RU-2745798-C1 (RU)
Title: Method for diagnosing allergic rhinitis
Inventor: Karpishchenko Sergej Anatolevich
IPC: A61B10/00
Filed: 2020-06-26
Granted: 2021-04-01
Abstract: FIELD: medicine.  
     SUBSTANCE: invention relates to medicine and otorhinolaryngology. The study is carried out among patients with negative prick test results for Dermatophagoides pteronyssinus. An allergen is introduced, and before and after that, patients are questioned with respect to the severity of the main nasal symptoms of the disease. The survey is carried out according to the modified visual analogue scale (m-VAS). Anterior rhinoscopy is performed. The parameters of the anterior active rhinomanometry (AARM) and the parameters of the acoustic rhinometry (AR) are determined sequentially for each half of the nose. When performing the AR, the volume of the nasal flow and the minimum cross-sectional area of ​​the nasal cavity in the right and left nasal passages are calculated in the segment from 0 to 22.0 mm from the entrance to the vestibule of the nasal cavity (MCSA1) and in the segment from 22.0 mm to 54.0 mm (MCSA2). The most ventilated nasal passage is established using additional AARM data such as nasal resistance in the inspiratory phase in each half of the nose at a pressure of 150 Pa. At the same time, the parameters of rhinoresistometry (RR) in the inspiratory phase are determined, which include data on nasal resistance at a volume flow rate of 250 ml/s. All measured parameters (the AARM, the RR and the AR) are considered initial. Then the study is continued, while all subsequent step-by-step measurements of indicators, namely, nasal flow velocity, nasal resistance, nasal flow volume, data from MPPS1 and MPPS2, are performed only for the most ventilated nasal passage. The obtained indicators are compared with the initial indicators, and with an increase in the value, the increase in the indicator in percentage terms is calculated using the formula: P 1 =((I 2 -I 1 )/I 1 )×100%  where I 2  is the measured value of the indicator; P 1  - increase in percentage of the indicator in relation to the initial values; I 1  is the initial indicator before the start of the test and when the value decreases, the decrease in the indicator is calculated in percentage terms using the formula: P 2 =((I 1 -I 2 )/I 1 )×100% where I 1  is the measured value of the indicator; P 2  - decrease in percentage of the indicator in relation to the initial values; I 1  is the initial indicator before the start of the test. At the same time, at the beginning of the study, a control liquid is used, after that solutions of the allergen are used. Then the calculation of the indicators of the increase in P 1  and the indicators of the decrease in P 2  are used to interpret the results of the study. If the changes in the P 1  and P 2  indices in relation to the initial values ​​are less than or equal to 20%, the examination is continued. In this case, the use of solutions containing the allergen begins with the lowest concentration of 10 -3  with a gradual transition to a solution containing the whole allergen. If the changes are less than 40%, solutions with allergen dilutions of 10 -2 , 10 -1  and the whole allergen are reused sequentially. The study is stopped if the result is interpreted as negative. In the absence of significant changes in rhinomanometric parameters, a patient is recommended to have planned surgical treatment by an otorhinolaryngologist. The study is also stopped if the result is interpreted as positive. The result is interpreted as positive if a patient’s condition worsens in accordance with the m-VAS scale to a pronounced degree or, in other words, there are at least 2 out of 4 symptoms. The result is considered positive if nasal resistance indicators increase by more than 40% during the AARM and the RR and if there is a decrease in the speed of the nasal flow by more than 40%. The result is interpreted as positive if MPPS1 indicators decrease by more than 25% during the AR and a patient is recommended to continue treatment with an allergist.  
     EFFECT: method improves accuracy and safety of allergic rhinitis diagnostics by differentiating patients, subjective analysis of allergy symptoms and objective assessment of local reaction of nasal mucosa in response to allergen exposure. The invention eliminates the risk of anaphylaxis in patients.  
     8 cl, 7 dwg, 1 ex